Provider Demographics
NPI:1366014714
Name:SHERIFF, HUNTER J
Entity Type:Individual
Prefix:
First Name:HUNTER
Middle Name:J
Last Name:SHERIFF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CHEYENNE BLVD APT 14
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80905-2406
Mailing Address - Country:US
Mailing Address - Phone:719-621-2088
Mailing Address - Fax:
Practice Address - Street 1:600 CHEYENNE BLVD APT 14
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80905-2406
Practice Address - Country:US
Practice Address - Phone:719-621-2088
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO111640861343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)